A Promising New Therapy for Itch By Dr. Charles B.
Goldberg, MS, MD Summary: Discussion of an anti-itch therapy that mimics the
anti-itch mechanism of UVB light. Itch is a particularly distressing symptom
for millions of patients suffering from skin ailments. Severe, chronic itch
can significantly reduce the quality of life and scratching can cause skin
damage and lead to infection. Limited advancements have been made in the
past several decades in the treatment of itch, so patients are faced with
the choice of continuing to suffer, using palliative OTC products that offer
only minor relief or expensive prescription treatments, such as steroid
creams that can damage skin and become less effective over time. A promising
new treatment for itch has come to my attention. DermaVive Inc, an Oregon
company located near my practice has introduced a unique product, DermaVive
Natural Itch Relief Cream. The product contains 0.1% Menthol, an FDA
approved itch ingredient and what the company calls “High Potency Vitamin D3
(HPD3)”. The founder of the company, Marilyn Strube, discovered the
anti-itch property of HPD3 while suffering from a severe case of chickenpox.
She used her background as a medical research biologist to determine the
mechanism of action. In doing so, she unraveled a medical mystery.
Ultraviolet B (UVB) light therapy is highly effective at relieving itch, but
researchers failed to understand why. A rich quantity of vitamin D3 is
formed in skin during exposure to sunlight, but since vitamin D3
formulations usually fail to relieve itch, vitamin D3 was not implicated.
Strube’s research determined that to achieve an anti-pruritic (itch) effect
in a topical treatment, a relatively high concentration of vitamin D3 is
required, along with a formulation that promotes sufficient absorption. The
company believes that HPD3 relieves itch in the same way that ultraviolet
light therapy does. Ultraviolet light therapy and HPD3 most likely work by
reducing elevated phosphate levels in itchy skin. The following is an
excerpt from the company website detailing the pathophysiology involved.
“Vitamin D is formed in skin during exposure to sunlight. The sun's energy,
specifically ultraviolet (UV) light, causes vitamin D to be formed from its
precursor, 7-dehydrocholesterol (3). A study reported in the American
Journal of Kidney Disease (2) demonstrated that the skin cells of patients
suffering with severe itch contained abnormally high concentrations of
phosphate ions. After treatment with ultraviolet light, the concentration of
phosphate ions was reduced to normal levels in 8 of 9 patients, along with a
corresponding reduction in itch. Molecules made partially of phosphate ions,
such as magnesium phosphate, are usually dissolved in the fluid inside the
skin cells. The study authors believed that at abnormally high
concentrations, these molecules precipitate, resulting in irritation of
nerve endings manifested as itch. If the phosphate is reduced, the molecules
dissolve back into solution with a resulting decrease in itch. Because
vitamin D is a principal and potent regulator of phosphate metabolism (1)
and because it is formed in the skin during exposure to ultraviolet light,
the authors speculated that vitamin D may have a role in the action of UV
light treatment for itch. The depletion of vitamin D may occur in skin
damaged by disease, burns, wounds, viral infections and aging. A number of
conditions have been proven to be associated with both severe itch and
vitamin depletion. These conditions include kidney failure, liver cirrhosis,
chickenpox, HIV infection and aging (4,5,6). Replenishing the vitamin D
topically is the most direct, effective and natural method of reversing the
mechanisms that lead to itch.” I agreed to give product samples to 30-40
clinic patients to test the product. Those patients were asked to evaluate
the product and fill out a questionnaire. Over 90% of the patients surveyed
experienced similar or better relief compared to conventional OTC or
prescription products. Surveys from two other clinics have yielded similar
results. I’m so impressed with the anti-itch effects of DermaVive Natural
Itch Relief Cream, I wish to pass the information on to others who may
benefit from it. I have agreed to act as an independent medical advisor to
the company, but otherwise have no affiliations with DermaVive Inc. Product
information and ordering are available at the company website at
www.dermavive.com. References: 1.
Cross H., Peterlik M. Effects of vitamin D and insulin on phosphate
transport in the differentiating chick small intestine. Calcium and
Phosphate Transport. 1981. Pp. 293-296. 2. Blackley J., et. Al. Uremic
pruritus: skin divalent ion content and response to ultraviolet
phototherapy. Am J Kidney Dis, Vol V, No 5, May 1985. 3. Martindale: The
Extra Pharmacopoeia 30th ed. 1993 4. Campos F., Flores H., Underwood B.
Effect of an infection on vitamin D status of children as measured by the
relative dose response (RDR). Am J Clin Nutr 1987:46:91-4. 5. Krawitt E.,
Grundman M., Mawer E. Absorption, hydroxylation, and excretion of vitamin D3
in primary biliary cirrhosis. Lancet, 1977, 1246-1249. 6. MacLaughlin J. and
Holick M. Aging decreases the capacity of human skin to produce vitamin D3.
J. Clin. Invest. Vol. 76 Oct. 1985. 1536-38.

Brief bio Currently
operating Sellwood Medical Clinic, a family practice in Portland OR I am a
member of: • AAFP, American Academy of Family Physician • AAAI, American
Academy of Allergy & Immunology • NAS, New York Academy of Science • AAS,
American Academy of Science • OAFP, Oregon Academy of Family Physicians •
NASEB, National Academy of Sciences and Experimental Biology, Several
research publications in the fields of Immunology and Dermatology (The
Lancet, Science, Proceedings of the Society of Science and Experimental
Biology, et al) and Family Practice (American Journal of Family Practice),
and others. Two year evaluation speaker re:generic vs. brand name Rx’s, and
other speaking engagements.